The Intermountain OSHA Questionnaire is a mandatory medical evaluation document based on federal OSHA Respiratory Protection Standards (29 CFR 1910.134). Intermountain Health requires PRN and contract clinicians to complete this preboarding form prior to working shifts to ensure medical fitness for wearing personal protective equipment (PPE), such as N95 respirators, in healthcare settings.
What does the questionnaire cover?
The screening evaluates whether a clinician can safely wear respiratory protection without adverse health effects during shift duties.
- Respiratory health: History of asthma, bronchitis, shortness of breath, or lung conditions
- Cardiovascular health: Heart conditions, high blood pressure, or chest discomfort during exertion
- Physical and medical conditions: History of seizures, diabetes, claustrophobia, or relevant physical limitations
- Workplace exposure: Tobacco use and past occupational exposure to hazardous airborne substances
Why is it required for Intermountain shifts?
Healthcare facilities present inherent risks of exposure to airborne infectious diseases and hazardous substances. While respirators provide crucial protection, wearing tight-fitting masks puts physical exertion on the respiratory and cardiovascular systems. Intermountain Health mandates this questionnaire to safeguard clinician health, comply with federal safety regulations, and maintain facility-wide infection control protocols.
What does it look like on a shift?
Completing the evaluation ensures you are cleared for respirator fit testing and immediate assignment to units requiring isolation protocols. On shift, it allows you to safely wear required PPE during high-risk patient interactions without administrative delays or compliance holds.
Complete your credential
If the credential is a facility-specific training or orientation, find the relevant course in ShiftReady or access the document through facility onboarding resources.
Adding it to your profile:
- Sign up or Log in to the Nursa app.
- Tap Menu in the top left corner of the app.
- Select Profile.
- Scroll to the Credentials section.
- Tap Add your Credential and choose Intermountain | OSHA Questionnaire.
- Upload proof of your credential (PDF, WORD, JPG, or PNG).
- Add any further required details (issue date, expiration date).
- Optional: Add a note with any necessary clarifying information.
Sign up as a clinician on Nursa and check whether the Intermountain shifts on your list require this credential before requesting them. For more guidance on nursing credentials and facility compliance, visit the Nursa Blog.
